麻豆传媒

Whether female patients receive better care from and prefer female doctors has yielded mixed evidence, but an American College of Cardiology (ACC) panel found enough to draw recommendations.

Six out of eight studies in its systematic review turned up an association between gender concordance and patient clinical outcomes, according to Malissa Wood, MD, of Massachusetts General Hospital in Boston, and colleagues from the ACC Disease in Women Section.

For example, showed that female diabetes patients were much less likely to receive treatment intensification for high blood pressure than male patients in a primary care setting -- particularly when they were treated by a male doctor -- and that female doctors were more likely than male peers to intensify therapy for hyperlipidemia and hypertension.

The ACC report was published in the March 2 issue of the .

Whether physician-patient gender concordance plays a part in the observed gender differences in patient outcomes is . And in the systematic review, only two out of five reports showed a link between gender concordance and patient preference (or trust of their physician).

Acknowledging the data on gender concordance as "very limited," Wood's group proposed three recommendations in the realm of cardiology.

First is to increase gender diversity in the physician workforce, which may be accomplished through interventions to address existing biases that have limited opportunities for women in cardiovascular medicine. Also helpful would be improved mentorship and a change in cardiology culture to be more female- and family-friendly.

Women now comprise the majority of medical students in the U.S., but women enter cardiology in "staggeringly low" numbers: only 12.6% of cardiologists are women despite drawing from internal medicine residency programs that are roughly split between the sexes, according to the authors.

"We must continue encouraging young physicians from diverse backgrounds to enter the field of cardiology in order for our physician workforce to more accurately reflect the gender composition of our overall patient population," said Wood in a press release.

Second, medical education should be gender- and sex-specific. Stressing patient-centered communication and care is key, as is implicit bias training in undergraduate and graduate medical education.

Finally, the ACC group recommended further research in patient-provider gender concordance.

"A better understanding of the mechanisms driving gender differences in patient outcomes, including whether patient-physician gender concordance truly impacts patient outcomes, can help guide targets for interventions," Wood said.

"More research is needed to understand the physician behaviors associated with improved patient outcomes, specifically in driving differential outcomes in gender patient-physician pairings, including drivers of implicit and explicit bias," she added.

Comment